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Big muscles and big nerves

C B Dabbs¹, L B Kline

¹Eye Foundation Hospital, Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, USA.

Survey of Ophthalmology

|December 24, 1997

Summary

This case study highlights a rare association between Graves disease and bilateral optic nerve sheath meningiomas. Orbital radiation therapy effectively managed vision loss and orbital symptoms, avoiding surgery and steroids.

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Area of Science:

Ophthalmology
Neurology
Endocrinology

Background:

Graves' disease is an autoimmune disorder often causing orbitopathy.
Optic nerve involvement in Graves' disease typically presents as compression due to extraocular muscle सूजन.
Bilateral optic nerve sheath meningiomas are rare tumors affecting vision.

Observation:

A 50-year-old woman with a history of Graves' disease experienced recurrent vision loss.
Systemic corticosteroids provided temporary visual recovery during exacerbations.
Imaging revealed bilateral optic nerve sheath meningiomas alongside Graves' orbitopathy.

Findings:

Orbital radiation therapy stabilized visual function and orbital inflammatory changes.
The patient no longer required systemic corticosteroids for her condition.
This is the first reported instance of co-occurring Graves' disease and optic nerve sheath meningiomas.

Implications:

This case suggests a potential, though unproven, link between Graves' disease and optic nerve sheath meningiomas.
Radiation therapy may be a viable treatment option for managing vision loss in such rare presentations.
Further research is warranted to explore the potential association and optimal management strategies.

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